Vascular screening · London
Private AAA screening, for the people the NHS programme was not built for.
A five-minute abdominal ultrasound. Painless, no radiation, no injections. The NHS offers it once to men in the year of their 65th birthday. If you sit outside that window and have reason to check, we arrange the scan and route the report to the right vascular consultant.
5 min
Abdominal ultrasound
single view of the aorta
The context
What the NHS screens for, and where private access fits.
The NHS AAA Screening Programme has been one of the most successful population screens of the past two decades. It is deliberately narrow: one ultrasound, one age band, one sex. That leaves real gaps.
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Men under 65 with family history
A first-degree relative (father, brother) with a known AAA raises your lifetime risk. The NHS programme starts at 65, so private screening bridges the gap.
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Women aged 65 and over with risk factors
Women are not offered NHS AAA screening. If you are a current or former smoker, or have hypertension, hyperlipidaemia or a family history, a one-off ultrasound is worth considering.
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Men over 65 who missed the NHS invitation
If the letter never arrived, or you moved, you can self-refer. The one-off scan is the same test.
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Surveillance after prior repair
After EVAR or open repair, structured follow-up imaging picks up endoleak, sac growth or graft complications early.
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Borderline aortic diameter
If a previous scan showed an aorta at the upper end of normal, interval surveillance is safer than waiting for symptoms.
What the numbers mean
Aneurysm size dictates the next step.
An AAA is defined as an aortic diameter of 3.0 cm or more in the subrenal aorta. Below that, the aorta is normal or ectatic. Above 5.5 cm in men (5.0 cm in women), rupture risk climbs steeply and repair is considered.
| Size band | What happens next |
|---|---|
| Ectatic (2.5-2.9 cm) | Not an aneurysm. Consider one-off recheck at 5 years if risk factors present. |
| Small AAA (3.0-4.4 cm) | Annual surveillance ultrasound. Aggressive cardiovascular risk factor modification. |
| Medium AAA (4.5-5.4 cm) | Three-monthly surveillance ultrasound. Vascular clinic review. |
| Large AAA (men greater than or equal to 5.5 cm, women greater than or equal to 5.0 cm) | Refer to vascular surgery for consideration of repair. CTA for planning. |
Ultrasound is the surveillance tool. Once a diameter approaches the repair threshold, or planning is needed, CT angiography is the gold standard because it maps the neck of the aneurysm, the iliac arteries and any accessory renal vessels.
Management and repair
Small aneurysms are managed, large ones are repaired.
The evidence base is settled. For small aneurysms, watchful waiting with risk factor modification. For large aneurysms, EVAR or open repair, chosen on anatomy and comorbidity.
Medical management
Stopping smoking is the single most effective intervention. It slows growth and cuts rupture risk. Add a statin, tight blood pressure control, and aspirin where clinically appropriate. Surveillance ultrasound at intervals set by size.
EVAR
A stent-graft passed up through the femoral arteries. Day-case or short stay, faster recovery. Requires lifelong surveillance CT angiography to detect endoleak or sac expansion. First-line for many patients under NICE NG156.
Open repair
Traditional retroperitoneal or transperitoneal approach. Five to seven day admission, longer recovery, but more durable as a single procedure with less follow-up imaging. Preferred in some anatomies and younger fitter patients.
For juxtarenal or thoracoabdominal aneurysms, custom devices with fenestrations (FEVAR) or branches (BEVAR) preserve flow to the renal and visceral arteries. These are done in specialist centres. Rupture is a surgical emergency with mortality between 40 and 90 per cent, which is why detection at the surveillance stage matters.
Indicative pricing
Honest ranges across our London panel.
The initial screen is usually self-pay. Insurance often covers the vascular consultation and CTA when the diameter warrants investigation.
| Assessment | Indicative range | Duration | Report turnaround |
|---|---|---|---|
| Private AAA ultrasound (standalone) | £180-£320 | 5-10 min | Same day |
| AAA ultrasound with vascular consultation | £350-£550 | 30-45 min | Same day |
| Annual surveillance ultrasound | £150-£280 | 5-10 min | Same day |
| CT angiogram for pre-operative planning | £850-£1,400 | 15-20 min | 24-72 hrs |
London vascular centres
A small panel of teaching-hospital vascular units.
Introductions are made privately once we understand your case. All are consultant-led and offer EVAR, open and complex endovascular repair.
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St Mary's Vascular Institute (Imperial Private)
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Royal Free Vascular
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HCA The Wellington Vascular Assessment
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Guy's and St Thomas' Private Vascular
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London Bridge Hospital Vascular
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King's Private Vascular
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Cromwell BUPA Vascular
FAQs
The questions patients actually ask.
Straight answers on eligibility, thresholds, cost and what happens if the scan is abnormal.
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Who qualifies for private AAA screening if the NHS does not screen me?
The NHS AAA Screening Programme offers a one-off ultrasound to men in the year of their 65th birthday. Private screening is a sensible option for men under 65 with a first-degree relative who had an AAA, women aged 65 and over with cardiovascular risk factors (smoking, hypertension, hyperlipidaemia, family history), men over 65 who missed their NHS invitation, and anyone under surveillance after prior aneurysm repair or a borderline aortic diameter.
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What actually happens during the scan?
An abdominal ultrasound performed by a specialist vascular radiographer. You lie on your back, a small amount of gel is applied to the abdomen, and the maximum transverse diameter of the subrenal aorta is measured. The scan takes five to ten minutes and is painless. No injections, no radiation.
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What counts as an aneurysm, and when is it dangerous?
An abdominal aortic aneurysm is defined as an aortic diameter of 3.0 cm or more in the subrenal aorta. Small aneurysms (3.0-4.4 cm) rarely rupture and are watched annually. Medium aneurysms (4.5-5.4 cm) are scanned every three months. Large aneurysms (5.5 cm or more in men, 5.0 cm or more in women) meet the threshold for consideration of surgical repair, as rupture risk rises steeply above these diameters.
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What is the difference between EVAR and open repair?
EVAR (endovascular aneurysm repair) is a keyhole procedure. A stent-graft is passed up through the femoral arteries and deployed inside the aneurysm. Most patients go home the same day or after a short stay. It is less invasive but requires lifelong surveillance CT angiograms to check for endoleak. Open repair is a traditional operation through the abdomen or flank. It carries a longer hospital stay (5-7 days) and recovery but is more durable as a single procedure. NICE guideline NG156 supports both. Complex juxtarenal or thoracoabdominal aneurysms may need FEVAR or BEVAR, custom stent-grafts with fenestrations or branches to preserve blood flow to the kidneys and gut.
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If a small aneurysm is found, what can I do to slow its growth?
The single most effective intervention is stopping smoking. Smoking accelerates aneurysm growth and dramatically increases rupture risk. Good blood pressure control, a statin for cholesterol, and aspirin (where clinically appropriate) all help. There is no medication that reliably shrinks an aneurysm, but risk factor control buys time and lowers rupture risk while you are under surveillance.
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What does private AAA screening cost in London?
A standalone AAA ultrasound is typically £180-£320. Bundled with a vascular consultation, expect £350-£550. Annual surveillance scans run £150-£280. If a CT angiogram is required for pre-operative planning, budget £850-£1,400. Insurance often covers the CTA and consultation when medically indicated; the initial screen is usually self-pay.
Book your AAA screening
A five-minute scan can settle a question you have been carrying for years.
Tell us your age, family history and any cardiovascular risk factors. We come back within one working day with the right clinic, an indicative price and, if useful, a vascular consultant to review the result.